caa a22 4500 606155945 CHVBK 20210128100606.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s10096-015-2367-0 doi (NATIONALLICENCE)springer-10.1007/s10096-015-2367-0 Co-infection as a confounder for the role of Clostridium difficile infection in children with diarrhoea: a summary of the literature [Elektronische Daten] [H. de Graaf, S. Pai, D. Burns, J. Karas, D. Enoch, S. Faust] Although Clostridium difficile is a major cause of antibiotic-associated diarrhoea in adults, the incidence and severity of C. difficile infection (CDI) in children is unclear. One complicating factor in assessing the role of CDI in children is the possibility of co-infection with other gastrointestinal pathogens. In this review, we summarise the literature concerning C. difficile co-infections in young children, in an attempt to discuss the rate of co-infections and their potential role in the severity of CDI clinical presentation. We identified 31 studies where co-infections were analysed, comprising 1,718 patients with positive C. difficile tests. The pooled percentage of reported co-infections was 20.7% (range 0-100%). Viral co-infections were most commonly reported (46%), with bacteria and parasites accounting for 14.9% and 0.01% of cases, respectively. However, the panel of co-infections tested for varied considerably among studies and 38% of stated co-infections did not have a pathogen reported. Substantial variation in how and when tests for gastrointestinal co-infections are carried out, small sample sizes and a lack of clear CDI case definitions preclude meaningful conclusions on the true rate of co-infections in this patient population. This review suggests that co-infections may be common in children with diarrhoea who tested positive for C. difficile. Given a lack of CDI case definitions, especially in young children under the age of 5 years, a broad panel of pathogens should be tested for to exclude other microbiological causes. However, the summarised poor quality of the available literature on this subject highlights a need for further studies. Springer-Verlag Berlin Heidelberg, 2015 de Graaf H. Faculty of Medicine, University of Southampton and Southampton NIHR Wellcome Trust Clinical Research Facility C Level, West Wing, Mailpoint 218, University Hospital Southampton NHS Foundation Trust, Tremona Road, SO16 6YD, Southampton, UK aut Pai S. Clinical Microbiology and Public Health Laboratory, Public Health England, Addenbrooke's Hospital, CB2 2QW, Cambridge, UK aut Burns D. Astellas Pharma EMEA, 2000 Hillswood Drive, KT16 0RS, Chertsey, Surrey, UK aut Karas J. Astellas Pharma EMEA, 2000 Hillswood Drive, KT16 0RS, Chertsey, Surrey, UK aut Enoch D. Clinical Microbiology and Public Health Laboratory, Public Health England, Addenbrooke's Hospital, CB2 2QW, Cambridge, UK aut Faust S. Faculty of Medicine, University of Southampton and Southampton NIHR Wellcome Trust Clinical Research Facility C Level, West Wing, Mailpoint 218, University Hospital Southampton NHS Foundation Trust, Tremona Road, SO16 6YD, Southampton, UK aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/7(2015-07-01), 1281-1287 0934-9723 34:7<1281 2015 34 10096 https://doi.org/10.1007/s10096-015-2367-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 review-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-015-2367-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- de Graaf H. Faculty of Medicine, University of Southampton and Southampton NIHR Wellcome Trust Clinical Research Facility C Level, West Wing, Mailpoint 218, University Hospital Southampton NHS Foundation Trust, Tremona Road, SO16 6YD, Southampton, UK aut NATIONALLICENCE 700 1- Pai S. Clinical Microbiology and Public Health Laboratory, Public Health England, Addenbrooke's Hospital, CB2 2QW, Cambridge, UK aut NATIONALLICENCE 700 1- Burns D. Astellas Pharma EMEA, 2000 Hillswood Drive, KT16 0RS, Chertsey, Surrey, UK aut NATIONALLICENCE 700 1- Karas J. Astellas Pharma EMEA, 2000 Hillswood Drive, KT16 0RS, Chertsey, Surrey, UK aut NATIONALLICENCE 700 1- Enoch D. Clinical Microbiology and Public Health Laboratory, Public Health England, Addenbrooke's Hospital, CB2 2QW, Cambridge, UK aut NATIONALLICENCE 700 1- Faust S. Faculty of Medicine, University of Southampton and Southampton NIHR Wellcome Trust Clinical Research Facility C Level, West Wing, Mailpoint 218, University Hospital Southampton NHS Foundation Trust, Tremona Road, SO16 6YD, Southampton, UK aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/7(2015-07-01), 1281-1287 0934-9723 34:7<1281 2015 34 10096